Doulas comfort mothers during pregnancy and childbirth

Women of color value support from someone who shares their culture

(Charles Hallman/MSR News)

(l-r): Dr. Rachel Hardeman and Akmiri Sekhr-Ra

More than half of all women who gave birth in 2014 were women of color. Two University of Minnesota health policy professors note in a published article that a lack of diversity in the maternity workforce is “one of many contributors” to this country’s health disparities and limited access to health care for underserved populations.

Drs. Rachel Hardeman and Katy Kozhimannil in the Journal of Midwifery & Women’s Health published results from interviews with 12 local women of color who work with pregnant women as doulas. A doula is a trained professional who provides physical, emotional and educational support to women before, during and after childbirth.

The interviewed women were chosen from the Doula Access Project, a research endeavor, and were asked what motivated them to become doulas. They included three Blacks; three Native Americans; two Latinos; two African immigrants; one Karen, an Asian ethnic group from Burma and Thailand; and a Yemeni woman.

“The women that participated in the project really felt it was their calling, deeply seeded in their culture and history,” recalled Hardeman as she spoke to the MSR from her office. Among the study results, the two co-authors found that the work of Black doulas and other women of color doulas are often overlooked and unrecognized; many have a strong desire to support birthing women from their communities; and that being a doula honors a woman’s cultural beliefs, preferences, rituals or practices during pregnancy and childbirth.

“A lot of the work that we see around doulas and what they do has been focused on the majority culture “said Hardeman. “We talk about doulas as White, upper- to middle-class women who are primarily support for White, upper- to middle-class women.”

“There is a deep history in the African American community” of doulas, noted Hardeman, who had a doula assist during her pregnancy.

(Charles Hallman/MSR News)

Rachel Hardeman

“We’ve always been by a woman’s side,” stated Akhmiri Sekhr-Ra, a local certified perinatal educator who has been a doula for over 25 years. She estimated that she has helped in over 250 births during that time. She advises women who wants to be a doula that they must be available for the pregnant woman at any time “day or night.”

“I look for somebody who really believes it’s a calling and they are not in it to make money,” explained Sekhr-Ra. “It is not something that you can make money from. I really try to tell people in my training [that] if you say you want to do this, you’ve really got to really want to do this.”

The relationship between the doula and the pregnant woman “is key,” said Hardeman. She and her husband, a local physician, “studied the birthing process and came into the prenatal process well prepared. But we still felt it was important for me to have a doula.”

“Everybody has their role — the physician, the nurse — but the doula is really there for the mother,” said Sekhr-Ra, who was Hardeman’s doula. She helped her “envision” the birth experience.

“Even though my mother, my twin sister and my husband were there, having someone who was only there to make sure I felt safe, she helped to make sure that I was comfortable as I could be,” said Hardeman. “One of the things I remember is how the room felt — I didn’t want it to smell like a hospital room. So I had lavender oil and music playing.”

“I try to be the quiet one in the corner,” added Sekhr-Ra. “I know what the mom wants and I really try to help her make that happen if at all possible.”

Hardeman’s study concluded not only that doulas “feel a calling to their work,” but also that doulas could help improve birth outcomes and help reduce longstanding disparities in birth outcomes.

Hardeman and Sekhr-Ra strongly agree that doulas are needed for a variety of reasons, including support from someone from the mother’s own racial, ethnic or cultural community. “It’s like your own kind of mothering,” said Hardeman, “having somebody to be with you and who understands what you are going through.”

“It’s important for us to have someone there who looks like us — somebody that knows you,” said Sekhr-Ra.